Constipation

Question 1

Primary causes of constipation

Answer 1

Idiopathic or functional:
Not enough fibre or water, stress or anxiety

Question 2

Secondary causes of constipation

Answer 2

Hirschsprungs disease, CF, hypothyroidism, spinal cord lesions, sexual abuse, intestinal obstruction, anal stenosis, cows milk intolerance

Question 3

What is encopresis

Answer 3

Faecal incontinence, usually sign of chronic constipation where rectum becomes loosened and looses sensation. Only loose stools are able to bypass the blockage and leak out causing soiling

Question 4

What can cause encopresis

Answer 4

Spina bifida, Hirschsprungs, cerebral palsy, learning disability, psychosocial stress, abuse

Question 5

What is rectal desensitisation

Answer 5

Overtime when patients lose sensation of needing to open bowels and open less frequently. Start to retain faeces in rectum, leading to faecal impaction and rectum stretches more - more desensitisation

Question 6

Causes of not passing meconium in first 48 hours

Answer 6

CF, hirschsprungs

Question 7

Red flags in constipation

Answer 7

Not passing meconium
Neurological signs
Vomiting
Ribbon stool
Abnormal anus
Lower back pain
Failrue to thrive
Acute severe pain

Question 8

Management of constipation in children

Answer 8

Correct reversible factors
Movical
Disimpaction regime for faecal impaction
Encouragement